OPEN VS. CLOSED END VASECTOMY

 

 

A traditional vasectomy involves ligating (closing-off) each severed end of the cut vas deferens (“vas”). In an open-end vasectomy the testicular end is left open so that sperm can leak out to avoid pressure build-up in the epididymus. The open-end approach was developed in an effort to reduce the risk of a certain complication of vasectomy called congestive epididymitis (thought to result from pressure build-up in the epididymis) which can lead to epididymal orchitis (pain in the testicles). Back-pressure on the epididymis is thought to be one of the causes of “chronic post-vasectomy pain syndrome” which means pain in the testicles that can last for a long time and be hard to cure. 

When open-end vasectomies are performed, the surgeon will include a procedure called fascial interposition. This step involves sewing one end of the cut vas inside and one end outside of the vasal sheath. Generally the testicular end of the vas is sewn on the outside of the vasal sheath so that sperm will drain into the scrotum where it is reabsorbed.  However some surgeons sew the testicular end inside the sheath. The key is to isolate one end inside and one end outside to use the sheath as a barrier to prevent sperm from getting across.  

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